1982年 · 第95卷第05期

Rhomotoxin has specific pharmacologic lowering blood pressure and slowing heart rate action. It is not a central nervous system type antihypertensive agent. Its mechanism of blood pressure lowering action is not direct dilation of the peripheral blood vessels and has no relation with blood volume. Its pharmacologic action has no relationship with the sympathetic nervous system, but is related to the cholinergic muscarinergic system and may also be related to the intravascular receptor, while its negative chronotropic action is due to activation of the vagus through the sinus nerve.

Two cases of subarachnoid hemorrhage are reported. One is a case of secondary subarachnoid hemorrhage with sudden death, in which no causes of death were found in the brain or heart except 2 small hemorrhages in the posterior hypothalamus and severe fragmentation of cardiac muscle fibers. So it is postulated that the fatality could be due to cardiac arrhythmia initiated by a neural mechanism originating from the lesions in the posterior hypothalamus. The other is a case of recurrent attacks of spontaneous subarachnoid hemorrhage, each attack being associated with impairment of memory and prolongation of the Q-T interval, but with no cardiac arrhythmia or clinical syncope. Torsade de pointe is discussed as the cause of some sudden cardiac deaths and neural mechanisms ca.using cardiac arrhythmia.

Traditional Chinese medicine dates from the 18th-12th centuries BC and was applied in dealing with psychiatric problems at almost the same time. The theory of Chinese medicine and efficacy of single drugs and folk prescriptions are reappraised both clinically and theoretically. The results of treatment using traditional Chinese medicine and combined traditional Chinese and western medicine are obvious, but further studies are required.

The discovery of a naturally infected racoon dog Nyctereutes procyonoides Gray as a wild animal reservoir host of leishmaniasis is reported for the first time in China. Our findings are of great importance not only from the biologic but also from the epidemiologic point of view, for the control and prevention of leishmaniasis.

Partial cystic duct obstruction (PCDO) is a gallbladder disease characterized by biliary colic. During acute attack, symptoms and signs are very similar to those of cholelithiasis. However, oral cholecystography usually reveals no abnormalities during remission. Thus, most patients fail to be diagnosed early and treatment is delayed.

Total parenteral nutrition (TPN) is now accepted as an important life-sustaining treatment for patients whose nutritional intake has ceased or is severely curtailed. The article covers 76 cases receiving TPN treatment by central venous catheterization and 62 cases receiving nutritional support by peripheral vein, totalling 3,674 days. The patients achieved positive nitrogen balance, weight gain and wound healing during TPN treatment, but these results could hardly be achieved by peripheral nutritional support, if fat emulsion is not supplied. The complications decreased gradually from 1971 to 1980. It is important to set up a TPN team to care for the patient receiving parenteral nutritional treatment.

Time lapse cinemicrographic observations of 9 bone giant cell tumors cultured in vitro were undertaken during 2 years. Features of multinucleated giant (MG) cell migration are recorded. First, a tongue-like cytoplasmic process with a ruffled or semicircular border protrudes from the edge of the ex-plants. It takes about 10 hours for a MG cell to move out of the explants completely. These isolated free MG cells usually showed active ameboid movements. The veil-like cytoplasm with an undulating membrane incessantly changes contour. The nuclei of MG cells mostly collect in the central portion and only occasionally in the peripheral cell zone. Vacuoles of varying size are frequently found in the cytoplasm, but most of them resolve in a short time. An outspread MG cell at times contracts, forming a spherical or oval cell in which the nuclei are no longer seen distinctly. Vigorous MG cell and stromal (St) cell pinocytosis and phagocytosis are visible. St cell mitosis has been recorded, but this process is not seen in the MG cell in this study. Cellular contact accompanied by intracytoplasmic granule delivery exchange through the intercellular gap junction is shown. This phenomenon probably represents cellular direct communication. The most interesting finding observed is natural fusion of 2 MG cells. The fused giant cell dies in 24 hours and St cells soon gather around it and vigorously phagocytize the remains which clear up in 7 days.

The author reports laryngeal functional restoration after total laryngectomy in 20 cases, 15 with total restoration, 4 partial restoration and 1 failure, with emphasis upon operative technic, indications, postoperative decannulation, mechanism and factors affecting laryngeal functional restoration.

In 30 therapeutically aborted fetuses at the intrauterine ages of the fourth to eighth month from an endemic goiter region, the thyroid gland was examined morphologically. Fetal and maternal serum T3, T4 and TSH were assayed. The results were compared with the data of 20 other therapeutically aborted fetuses of the same intrauterine ages from a nonendemic region. 13 fetal goiter cases from the endemic region group were studied. The thyroids were markedly increased in weight and size and showed the following histologic features: Follicular hyperplasia with high cuboidal or columnar epithelia lining acini containing little or no colloid; cellular hyperplasia with formation of solid cell masses; prominent hyperemia of perifollicular capillaries and presence of foci of enlarged follicles distended with colloid. Enlargement of the thyroid gland occurred early in fetal life. The cause of fetal goiter in this series was presumably iodine deficiency, as was true for endemic goiter in the same region. The morphogenesis of fetal goiter was presumed to be similar to that of acquired iodine deficiency goiter. Changes of the thyroid gland are apparently the result of increased serum TSH, a feedback stimulation of decreased serum T4 concentration. The fact that the serum TSH was markedly elevated and T4 decreased in the goitrous fectuses of this series strongly supports this hypothesis.

Monthly semen samples of 28 fertile men treated with 15-20 mg/day enteric-coated gossypol tablets, formic acid gossypol or acetic acid gossypol were examined by light microscope and electron microscope until antifertility was reached. Some cases were also studied ultra-histochemically for adenosine triphosphatase activity. The controls were the subjects own samples before treatment. By counting the morphologic changes of the spermatozoa, it was found that gossypol may cause marked 30% to 69% increases in abnormalities l.5 months after the start of administration. Electron microscope showed that the heads of aberrant spermatozoa often presented with large vacuoles with membranous structures in the nuclei and the acrosomes of some cells were abnormal or even completely lacking. The middle-pieces had irregularly arranged mitochondria and the cristae were decreased or even absent and the matrix became paler. The mitochondria were vacuolated. Control ATPase positive reactions on the outer and inner mitochondrial membranes were in general stronger than in the gossypol treated and the vacuolated mitochondria always were negative. As the drug took effect, the spermatogenic cells, mainly spermatids, were markedly increased to 10-100% and some spermatids had 2 to 4 nuclei. Sertoli's cells were seen in the semen. In general, the higher the cell differentiation, the more gossypol sensitive it is.